• Job Description

  Req#: JR 2025-101889

  Primary Location:

  Work From Home - KY - ULP - AMG

  Address:

  Home Office Remote, KY 40601

  Shift:

  First Shift (United States of America)

  Job Description Summary:

  The team member performs highly technical and specialized functions for the Central Business Office (CBO). The team member reviews, analyzes, and codes diagnostic and procedural information that determines Medicare, Medicaid, and private insurance payments. The primary function of this position is to perform ICD-10 CPT and HCPCS coding for reimbursement. The coding function is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations, and accreditation guidelines.

  Job Description:

  Essential Functions:

  • Obtains copies of chart notes, reports, electronic medical records, and any other necessary records for purpose of review

  • Identifies and communicates deficiencies that impact the billing process

  • Reviews documentation needed to clarify or complete the information required for compliant coding and billing of services performed

  • Abstracts patient evaluation and management services, including consultations, and bedside procedures for the purpose of selection of the appropriate HCPCS code(s), ICD-9 code(s), and modifier(s)

  • Ensures that documentation meets the Teaching Physician Rules as mandated by the Center for Medicare and Medicaid Services (CMS) and UofL Health policies prior to release of a code for billing

  • Ensures that documentation for Advanced Practice Providers meets the payer specific rules prior to release of a code for billing

  • Provides comments/suggestions relative to weak areas identified in the coding reviews

  • Provide trending deficiencies to CBO Manager and Compliance Educator, as appropriate

  Other Functions:

  • Works within a team environment to meet monthly goals

  • Maintains compliance with rules and regulations regarding coding

  • Develops daily/weekly communication with providers

  • Follows production and quality standards for coders as established.

  • Responds in a timely manner to questions from providers, department representatives

  • Maintains compliance with all company policies, procedures and standards of conduct

  • Complies with HIPAA privacy and security requirements to maintain confidentiality at all times

  • Performs other duties as assigned

  A Note on Required Qualifications:

  The Certified Professional Coders (CPC) certification through American Association of Professional Coders (AAPC) is required.

  Either Certified Coding Specialist (CCS), Certified Coding Specialist Physician-based (CCS-P) or Certified Coding Associate (CCA) certification through American Health Information Management Association (AHIMA) is required for this role but not all three.

  Additional Job Description:

  MINIMUM EDUCATION & EXPERIENCE

  • High School education or GED required.
  • Must have and maintain Certified Professional Coder (CPC) certification through AAPC or must have and maintain CCA, CCS or CCS-P certification through AHIMA.
  • Three years direct coding experience and in depth Coding and HIPAA regulations for physician offices, preferred.

  SELECTION/ELIGIBILITY

  • Application
    • Current CBO employees must apply to internal remote position in order to be considered
    • Positions will be selected based in order of the following criteria:
      • Metrics
      • Attendance
      • Disciplinary action

  • • Current employees must meet the following criteria in order to be considered for remote positions within the CBO:
      • 90 days of consistent achievement of/or exceeding metric standards
      • No attendance or disciplinary actions within previous 6 months
      • Able to work independently and manage time

  KNOWLEDGE, SKILLS, & ABILITIES

  • Ongoing coding guideline knowledge is required
  • Advance knowledge of medical terminology, abbreviations, techniques and surgical procedures
  • Advance knowledge of medical codes involving selections of most accurate and description code using the ICD-9-CM, ICD-10-CM, CPT, HCPCS, and IHS coding conventions.
  • Advance knowledge of medical codes involving selection of most accurate and descriptive code using the CPT codes for billing of third party resources
  • Skill in correlating generalized observations/symptoms (vital signs, lab results, medications, etc.) to a stated diagnosis to assign the correct ICD-9-CM, ICD-10-CM code
  • Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
  • Requires the knowledge of the business use of computer hardware and software to ensure the effectiveness and quality of the processing and presentation of data
  • Strict compliance with all coding guidelines at all times.
  • Working in a highly accurate and yet efficient manner.
  • Strict attention to detail in both coding and EMR entries.

  WORKING CONDITIONS

  • Sedentary Work: Lifting 10lbs. maximum and occasionally lifting and/or carrying items as needed.
  • Frequent Talking (Expressing or exchanging ideas by means of the spoken word.)
  • Frequent Hearing (Perceiving the nature of the sounds by the ear.)
  • Frequent Seeing (Visual acuity, depth perception, field of vision, color vision).
  • Consistent use of hand movement for keyboarding purposes.
  • Concentration varies depending on the tasks at hand. High levels of mental concentration are required. Must handle multiple tasks simultaneously and is subject to interruptions. Physical effort requires sitting and reaching with hands and arms. Manual dexterity, visual acuity, and the ability to speak and hear are required

  JOB REQUIREMENTS

  • Candidates upon hire will complete an electronic I-9 verification.

  • Only those candidates whose experience best meets our requirements will be contacted.
  • University of Louisville Physicians is an Equal Opportunity Employer.
  • Current UofL Physicians employees must follow the UofL Physicians Internal Transfer Policy .

• About the company

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